Submitted in response to CREG announcement DCCP-21, April 21, 1976: Reasons for Variation in Cancer Patient Survival by Race. This study will examine ethno-racial variations in cancer patient survival for the five major ethnic groups in Hawaii: Caucasians, Japanese, Chinese, Filipinos and Hawaiians. Sites examined will include colon-rectum, stomach, breast and lung. Our hypothesis is that observed differences, even when correlated with biological factors such as extent of disease at diagnosis, will ultimately be explained by socio-economic or cultural differences among these ethno-racial groups. Using basic data already collected by the Hawaii Tumor Registry (HTR), a member of the SEER program, we will first examine relative survival rates by race, controlled for extent of disease at diagnosis. Further comparison will be made on other biological and medically related factors such as age, sex and histologic type. Indirect correlations of relative survival rates by race will then be made with case-matched census tract characteristics, with socio-economic indices created from various groupings of these characteristics. Based on the results of these initial analyses, indicators of high and low risk for survival will be developed. These indicators will be used to select from the HTR files about 250 low and 250 high risk recent cancer cases of selected sites, matched on confounding variables. These individuals or surviving family members will be interviewed in depth, in an effort to uncover the underlying bases for the observed socio-economic and cultural associations with survival. As a result of follow-up surveillance on these groups, we will be able to test with individual rather than aggregate data the relationship of sociocultural factors to cancer patient survival.